Prognostic significance of leukopenia in childhood acute lymphoblastic leukemia

Shiozawa,Yusuke; Takita,Junko; Kato,Motohiro; Sotomatsu,Manabu; Koh,Katsuyoshi; Ida,Kohmei; Hayashi,Yasuhide

doi:10.3892/ol.2014.1822

Prognostic significance of leukopenia in childhood acute lymphoblastic leukemia

Authors:
- Yusuke Shiozawa
- Junko Takita
- Motohiro Kato
- Manabu Sotomatsu
- Katsuyoshi Koh
- Kohmei Ida
- Yasuhide Hayashi
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Affiliations: Department of Pediatrics, The University of Tokyo Hospital, Tokyo 113‑8655, Japan, Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama 339‑0077, Japan, Department of Hematology‑Oncology, Gunma Children's Medical Center, Shibukawa, Gunma 377-0061, Japan, Department of Pediatrics, Teikyo University Mizonokuchi Hospital, Kawasaki, Kanagawa 213-8507, Japan
Published online on: January 24, 2014 https://doi.org/10.3892/ol.2014.1822
Pages: 1169-1174

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Abstract

Chemotherapy‑induced leukopenia has been shown to be associated with the outcomes of several types of cancer, but the association with childhood acute lymphoblastic leukemia (ALL) remains unknown. To elucidate the association of chemotherapy‑induced leukopenia with the clinical outcome of childhood ALL, retrospective analysis was performed on 19 child patients with ALL treated according to the ALL‑BFM 95 high‑risk (HR) protocol. The mean minimum leukocyte count over the first three courses of the consolidation phase was used as the measure of hematological toxicity and ranged between 200 and 1,167/µl. The risk of relapse was significantly higher in patients with a mean minimum leukocyte count above the median of 433/µl (hazard ratio, 6.61; P=0.047). In conclusion, chemotherapy‑induced leukopenia was found to correlate with relapse‑free survival in childhood HR ALL. Dose escalation based on hematologic toxicity must be prospectively studied.

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